Evidence map›Paper›PMID 30269421›Full record

ArticleJournal of cachexia, sarcopenia and muscle2018

Poor performance of psoas muscle index for identification of patients with higher waitlist mortality risk in cirrhosis.

Maryam Ebadi, Connie W Wang, Jennifer C Lai, Srinivasan Dasarathy, Matthew R Kappus, Michael A Dunn, Elizabeth J Carey, Aldo J Montano-Loza, From the Fitness, Life Enhancement, and Exercise in Liver Transplantation (FLEXIT) Consortium

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  16. Psoas Muscle Index, Systemic Inflammation, and Liver Fibrosis in MAFLD: A Case-Control Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Maryam EbadiDivision of Gastroenterology and Liver Unit, University of Alberta Hospital, Edmonton, AB, Canada.
Connie W WangDivisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA.
Jennifer C LaiDivisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA.
Srinivasan DasarathyDivision of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA.
Matthew R KappusDivision of Gastroenterology and Hepatology, Duke University Medical Center, Durham, NC, USA.
Michael A DunnCenter for Liver Diseases, Liver Research Center, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
Elizabeth J CareyDivision of Gastroenterology and Hepatology, Mayo Clinic in Arizona, Phoenix, AZ, USA.
Aldo J Montano-LozaDivision of Gastroenterology and Liver Unit, University of Alberta Hospital, Edmonton, AB, Canada.
From the Fitness, Life Enhancement, and Exercise in Liver Transplantation (FLEXIT) Consortium

Funding

Project Two - Exercise Training Decreases Alcohol Drinking by an FGF21-Dependent MechanismP50AA024333 · NIAAA · CLEVELAND CLINIC LERNER COM-CWRU · PI LAURA E. NAGY · 2016 to 2026
$19.6M
Mechanisms of Malnutrition in Cirrhosis with Portosystemic ShuntingR01GM119174 · NIGMS · CLEVELAND CLINIC LERNER COM-CWRU · PI DASARATHY, SRINIVASAN · 2017 to 2020
$1.2M
NIAAA NIH HHS P50 AA024333NIGMS NIH HHS R01 GM119174
6 · The paper itself

Abstract

backgroundSarcopenia, characterized by low muscle mass, associates with mortality in patients with cirrhosis. Skeletal muscle area in a single computed tomography image at the level of the third lumbar vertebrate (L3) is a valid representative of whole body muscle mass. Controversy remains regarding applicability of psoas muscle to identify patients at greater risk of mortality. We aimed to determine psoas muscle index (PMI) association with skeletal muscle index (SMI) and to evaluate the capacity of PMI to predict liver transplant waitlist mortality.

methodsWe evaluated listed adult patients with cirrhosis from 2012 to 2013 at four North American liver transplant centres. From L3 computed tomography images within 3 months of listing, we determined SMI and PMI expressed by cm

resultsOf 353 waitlist candidates, 68% were men, mean age 56 ± 9 years, and Model for End-stage Liver Disease of 16 ± 8 points. Low SMI was present more frequently in men than women (51 vs. 36%, P = 0.02). Moderately strong correlation between SMI and PMI was observed (r > 0.7, P < 0.001). Low PMI (males < 5.1 cm

conclusionsSkeletal muscle index is a more complete and robust measurement than PMI, especially in men with cirrhosis. Low PMI identifies an incomplete subset of patients at increased risk of mortality indicated by low SMI. Given the poor performance of PMI, SMI should not be substituted by PMI.

Indexed as

AgedBiomarkersComorbidityFemaleHumansKaplan-Meier EstimateLiver CirrhosisLiver TransplantationMaleMiddle AgedOrgan SizePrognosisPsoas MusclesRisk AssessmentRisk FactorsSex FactorsBiomarkersComputed tomographyEnd-stage liver diseasePrognosisSarcopenia

Identifiers

PMID30269421
PMCPMC6240754

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.